ECC REIMBURSEMENT REQUEST-BOARD
ECC Board members should complete this form if you have spent personal funds on planned or emergency purchases for ECC. Receipts can be given to the Treasurer or emailed to the Treasurer at (ecchargers.treas@gmail.com). Please ensure all pertinent info is viewable if emailed.
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Your First & Last Name *
Today's Date *
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Date of Purchase *
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Store Where Purchase was Made *
Total Amount of Purchase *
Purpose/General Description of Items Purchased *
How did you submit your receipt to the Treasurer? *
Date Receipt was submitted to Treasurer *
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I attest that these funds were used only for the ECC organization and not for personal use and understand that I will be reported to all proper authorities should it be determined by the Board that funds were improperly used. I understand that the Board may not reimburse funds that were not properly approved or utilized. I also understand funds will not be reimbursed if a receipt has not been submitted successfully to and accepted by the Treasurer. *
Your Digital Signature *
Submit
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